The mission of the Center for American Indian and Rural Health Equity (CAIRHE) is to reduce significant health disparities in Native and rural communities across Montana while developing junior faculty into a multidisciplinary cohort of independent health equity investigators. The Center achieves its mission through community-based participatory research (CBPR) and public health interventions that are considerate of and consistent with communities' cultural beliefs. Montana communities face severe health disparities that affect health equity and quality of life among its citizens. As the only center at Montana State University focusing on Native and rural health, and as a research center for the state of Montana as designated by the Montana University System Board of Regents, CAIRHE will work during its COBRE Phase II period to combine rigorous science and interventions with thoughtful community engagement. The overarching aim of the Center's COBRE Phase II grant is to position CAIRHE as the state and regional leader in multidisciplinary, community- based health equity research, and to strengthen the Center's Career Guidance Plan and Sustainability Plan to increase the number of Center investigators achieving independent status. During Phase II, through both research and pilot projects, CAIRHE will develop health interventions and systems analysis of care to underserved populations in the areas of substance abuse and mental health, nutrition and chronic disease prevention, and infant and maternal health outcomes in line with the state's latest community health assessment needs. The Center will continue to develop a critical mass of health equity researchers in Montana by hiring one or more faculty investigators, by training junior investigators in health research design and CBPR, and by executing its Career Guidance Plan targeting independent status for investigators. Furthermore, during the period CAIRHE will enhance its collaborative Montana IDeA Community Engagement Core, shared with two other Institutional Development Award (IDeA) programs at MSU, to support health equity research in Native and rural communities. The Center also will expand its use of the Community Engagement and Research Mobile Lab, serving rural and frontier communities, and increase Community Advisory Board capacity statewide. The Center will expand translational biomedical research capacity within both the Center and the university at large through the Translational Biomarkers Core established during Phase I. As part of the Center's broader Sustainability Plan, CAIRHE will continue to build its regional Health Equity Network of partners?including clinical organizations, public health agencies, foundations, and other stakeholders?in order to expand health equity research, collaboration, funding sources, and dissemination.